TY - JOUR
KW - Canada
KW - Capitation Fee
KW - Cost-Benefit Analysis
KW - Fee Schedules
KW - Fee-for-Service Plans/economics
KW - Humans
KW - Mental Disorders/economics/therapy
KW - National Health Programs/economics
KW - Patient Care Team/economics
KW - Physician Incentive Plans/economics
KW - Primary Health Care/economics
AU - C. S. Dewa
AU - J. S. Hoch
AU - P. Goering
A1 - 
AB - OBJECTIVES: To consider the most common primary care reimbursement structures, to identify incentives inherent in each, and to discuss how each could be used to encourage a shared-care approach to treating mental disorders at the primary care level. METHOD: Three major financial reimbursement models--fee-for-service, capitation, and blended payment mechanisms--are examined. Each is considered in terms of its risk-sharing elements and the consequent incentives. We offer several scenarios to illustrate how the shared-care practice model might be encouraged under each financing mechanism. RESULTS: The current fee-for-service system does not encourage shared care. For wide adoption of the shared-care practice model, there must be a change in the reimbursement system's incentives. While none of the financing mechanisms offers a perfect solution, each has potential. Each, however, must be carefully tailored to its environment. CONCLUSIONS: Financial considerations are just one aspect to achieving shared care. Nevertheless, in designing a system to encourage collaborative, coordinated care for those suffering from mental illness, decision makers should be wary of creating or maintaining obstacles (financial or otherwise) to provision of accessible, high-quality care.
BT - Canadian journal of psychiatry.Revue canadienne de psychiatrie
C5 - Financing & Sustainability
CP - 6
CY - Canada
IS - 6
JF - Canadian journal of psychiatry.Revue canadienne de psychiatrie
N2 - OBJECTIVES: To consider the most common primary care reimbursement structures, to identify incentives inherent in each, and to discuss how each could be used to encourage a shared-care approach to treating mental disorders at the primary care level. METHOD: Three major financial reimbursement models--fee-for-service, capitation, and blended payment mechanisms--are examined. Each is considered in terms of its risk-sharing elements and the consequent incentives. We offer several scenarios to illustrate how the shared-care practice model might be encouraged under each financing mechanism. RESULTS: The current fee-for-service system does not encourage shared care. For wide adoption of the shared-care practice model, there must be a change in the reimbursement system's incentives. While none of the financing mechanisms offers a perfect solution, each has potential. Each, however, must be carefully tailored to its environment. CONCLUSIONS: Financial considerations are just one aspect to achieving shared care. Nevertheless, in designing a system to encourage collaborative, coordinated care for those suffering from mental illness, decision makers should be wary of creating or maintaining obstacles (financial or otherwise) to provision of accessible, high-quality care.
PP - Canada
PY - 2001
SN - 0706-7437; 0706-7437
SP - 488
EP - 495
EP - 
T1 - Using financial incentives to promote shared mental health care
T2 - Canadian journal of psychiatry.Revue canadienne de psychiatrie
TI - Using financial incentives to promote shared mental health care
U1 - Financing & Sustainability
U2 - 11526804
VL - 46
VO - 0706-7437; 0706-7437
Y1 - 2001
ER -